LEAD Scholar Update Form

Prior to the beginning of each new semester, all LEAD Scholars MUST fill out this form in order to receive LEAD scholarship distribution for the upcoming semester. This form provides information needed to confirm your plans to enroll and your participation in the LEAD Scholars program. If you have questions, please ask them in the “Comments/Questions” section.

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Is Student?

YesNoPopulated via pre-fill

Alumni ID

Populated via pre-fill

Relevant Semester

This should be updated each semester when other dates are updated on the form

Due Date: Monday, November 27th

Confirm General Information

First Name

Last Name

Uniqname

U-M ID

If you need to correct your primary name, please contact the Registrar's Office at [email protected] OR (734) 647-3507.

Date of Birth:

Pronouns

Tell us your unique pronouns

Enrollment Status

Please explain the previous answer

Please specify program and location

Where will you be primarily living throughout the semester?

Residence Hall

Campus or Local Street

Campus or Local City

Campus or Local State / Province

Campus Zip/Postal Code

Campus or Local Country

Confirm Your Contact Information

Primary Email Address Type

Primary Email Address

Secondary Email Address

Preferred Phone Type

Preferred Phone

e.g. 8008474764

Home Street

Home City

Home State / Province

Home Zip/Postal Code

Home Country

Confirm Emergency Contact Information

Please include the name and contact information for a Primary Emergency Contact, who will only be contacted in an emergency situation. A contact can include a parent, guardian, sibling, other family member, friend, etc.

Name

Email Address

Preferred Phone Type

Phone Number

e.g. 8008474764

Confirm Academic Information

Campus

Anticipated Graduation Month

Anticipated Graduation Year

School/College you are enrolled in:

Additional School/College you are enrolled in:

List your other School(s)/College(s)

Major or Concentration

Additional Majors, Concentrations, and Minors:

Extracurricular Activities

Name your student activities similar to how they appear on Maize Pages, if applicable. Activities outside of Maize Pages are also accepted. No acronyms or abbreviations, please.

Student Org/Extracurricular Activity

Student Org/Extracurricular Activity Position